Treatment for prostate cancer can have serious side effects. Here, male patients describe how it affected them.
While the side effects listed below are the most common ones, not all men will experience them. Some will have short-term discomfort and make a good recovery, while others may experience longer-term symptoms which may require lifestyle changes.
The men's names have been changed to protect their privacy.
If your urinary incontinence is mild, you may be able to control it by learning some simple exercises. Pelvic floor exercises can strengthen your control over your bladder. For more severe cases, surgery may be necessary.
- Bill had radical prostatectomy after he was diagnosed with prostate cancer aged 66
Bill was incontinent for six months after the surgery and says during that time his life had to be divided into 40-minute slots. "The sort of nappy-type pads that I wore had a 40-minute lifespan," he says. "If I was going to go to the cinema or anything of that sort, everything had to be worked out in 40 minutes.
"I was still very pleased I'd had the surgery. I would never have not had the surgery because of it." Bill was considering changing his lifestyle as a result, but then he started getting better.
- Anthony had brachytherapy after he was diagnosed aged 59
After the treatment, Anthony experienced bladder pain and had trouble passing water. He says: "[I was also] passing water far too often to get involved in doing anything else. This obviously leads to a lack of confidence and you don't feel like leaving the house." He says his condition has gradually improved and as a result so has his confidence. "I can go out of the house and travel about now and it's getting back to normal," he says.
- Simon was 54 when he was diagnosed and had a radical prostatectomy
Simon was given male incontinence pads after his treatment to deal with what he calls "dripping". He says not many chemists stocked them and he would often run out of them. He says: "I'd advise anybody to make sure their local chemist has got them in for you, as our local chemist only had one pack." He says the pads are not uncomfortable but he found the drip sensation annoying. He has since been able to return to work as a builder. "I haven't worn pads now for the last four or five months," he says. "I get a drip now and again but it's mostly if I put my legs wide apart."
There are a number of treatments available for erectile dysfunction, including drugs to increase blood flow, such as Viagra, injections to produce an erection, vacuum pumps and surgical implants.
- Nigel had radical prostatectomy after he was diagnosed aged 56
Nigel says his sex drive has gradually diminished since his treatment. "It became very limited," he says. He is unable to have or maintain an erection. "That isn't a huge problem to me and my wife," he says. "We've learnt to come to terms with it. It was something we didn't want and we would've preferred not to have had, but it's secondary to everything else. Both of us are here and we get on with our life."
- Angus was diagnosed aged 68 and had surgery and hormone therapy
Angus didn't find it too hard to come to terms with impotency. "At 70 I'm not that worried," he says. "It hasn't altered my relationship with my wife. By the time we reached 70, it wasn't the end of the world. It just doesn't happen any more. I think our relationship is fine, we're as affectionate as we always were but there isn't any sexual activity."
- Charles had hormone treatment after he was diagnosed aged 66
Charles says he and his wife are not that bothered about his impotence. "In a younger man I think the impotence would worry them because it might affect their married life. It depends how the relationship between the husband and wife is. In my case, we've got three grown-up daughters now and my wife isn't bothered in any way. It doesn't interest her any more so we get along well together."
In fact, Charles' wife tells him that the hormone therapy has made him more even-tempered. "She says I'm more relaxed now than I've been in all the years she's known me," says Charles.
Bowel and bladder problems
Bowel dysfunction is mainly a side effect of radiotherapy. Short of treating individual symptoms as needed, there are few, if any, treatment options for bowel dysfunction after radiotherapy.
- Frank was diagnosed aged 66 and had radical prostatectomy
On top of urinary incontinence and impotence, Frank developed symptoms of a dilated colon, called a mega-colon. "It becomes almost like a reservoir, so instead of being a muscular tube which is going to propel the faeces along, it becomes a collecting tank for faeces," he says. It was a condition Frank found particularly difficult, especially as he had a weak pelvic floor that weakened his bowel control even further.
- Tim had radiotherapy after he was diagnosed at the age of 67
Following treatment, Tim had severe diarrhoea which lasted for about three weeks. He was warned beforehand that his rectum would probably be injured as a consequence of the radiotherapy. He says: "That was all explained to me, but you don't know what it means until you get it. We were all prepared for it so coped with the consequences, which lasted about three weeks after the treatment. It's gradually got better since."
- George had radiotherapy after he was diagnosed aged 66
The radiotherapy caused damage to George's rectum, called proctitis, an inflammation of the anus. He says: "The result is that you have to keep your bowels as regular as you possibly can, because if you don't you'll just aggravate it and make it worse. And also the frequency is increased. Instead of possibly just going once or twice a day, you know at the extreme you might have to go three times a day, but the plus side is you do go as soon as you wake up."